Insurance HELP PLEASE!

So, I have been using Liberty Medical to get my pump supplies and Dexcom supplies for the last 14 months. My insurance has paid 100%. I've had no copays. Liberty just sends me my supplies on a regular basis. Well, on Friday, I saw that my insurance denied my claim for the supplies and said I was responsible for $4000! I called them and they said that Liberty is now out of network with my plan because Liberty did not renew their contract!!??? What the freak?!! I JUST got supplies in December and everything was FINE!!! Any suggestions? Please help!!! This doesn't make sense to me?!!! How can they be in-network one minute and out of network the next???!!!

I would call your insurance directy. Often they have a “patient advocate” you could speak with. Or maybe someone else there could help. It may be as simple as them switching to a different provider… Hopefully… Good luck…

I agree with Sam, but also you should call Liberty Medical. You may have to go with a different supplier, but sometimes the negotiations to stay in network run over into the next year, so they are "out" until the new papers get signed, then they're back "in".

It's a maddening thing!

You have to find a new vendor, they should tell you who it is although one of my FB friends w/ a husband and 2 pretty small kids is rationing their supplies, saving them for the kid w/ the most wild fluctuations, because her insurer won't tell her from whom they will cover the supplies. I don't recall if this was Liberty Mutual or not but it seems like a very dangerous game they are playing. I would think that it could be argued that there's some sort of conspiracy or collusion which would cross some sort of line to be improper in some manner.

I received a letter from PrimeMail, the Blue Cross preferred supply vendor, that said they weren't sending out any supplies because they needed a letter from my doctor, a process which I consider insultingly stupid, but by the time I got the letter and called them to rip them a new one, the guy said they had already received the letter from the doc and the supplies were on the way. They have toned the letter down from one's I'd received several years running, that would cite the idiots at Medicare as some sort of proof that I only "needed" 4x strips/ day, that seemed to sort of smugly dare my doctor to explain why I might need more. Which he did so they sent them. This year, there's nothing about the 4 strips in their letter but the fact that they spend .40 plus the cost of their people to mail letters (probably low, as these processes are highly mechanized...) plus having to have a guy staffing the place on Saturday to field my call is a total waste of health care dollars.

If it ever reaches the point where they deny coverage for > 4 or 7 or some other number of strips, I will certainly try to find a lawyer specializing in class-action suits to see if we can make a decent case there. I suspect that it would not be difficult to produce evidence of collusion and impropriety on their side of this whole process.

Thank you so much! My insurance did tell me that Edgepark was in network so I will be able to get my supplies still so that is good. But what I am really worried about is the $4,000 bill that I could get blamed for since this is considered out of network all of the sudden!!!! How in the world is this stuff considered LEGAL!!??? I just don't get it. The way insurance is ran in American should be considered a federal crime. I run my own business and I can't just one day tell someone they owe me nothing and then after I provide a service to them send them a bill for $4,000!!! That's criminal!!!

Thank you Mike! I didn't realize this and yes it is a maddening thing!!!

Yes, I agree. There are so many of us dealing with this crap. We really need to band together and try to start making some headway. This isn't right. I'm also dealing with a very inept third-party mandated supplier for an injectable medications for my RA. They are always late sending my medication, can't ever find my prescription, and the list goes on and on. Thankfully, I won't die from a missed dose or a late dose. But here is the thing, this is the ANTHEM BCBS supplier for people who have HIV, Cancer, and other VERY serious illnesses. When these people don't get their things in time...they die. Something has GOT to change!

Insurance is starting to dicate who lives, who dies....who gets to have better health because they get more test strips and who gets to have poor health because they are being denied the things they need!

Be careful with any supplier. I had Edgepark and they sent me supplies without checking my coverage. So - you have to be on top of them all the time. I had to get Dexcom involved. So check with your insurance at the end of next year just to make sure that Edgepark is still the provider.

It so sucks to have diabetes because we have to constantly fight for what we need.... Hang in there and hope everything goes well!